By Andy Birkey
The Minnesota Independent
1/23/09
Sen. Linda Berglin chairs the powerful Health and Human Services Budget Division in the Minnesota Senate and has long advocated a managed-care approach to rising health care costs. Although a staunch progressive on health care policy (she helped create and protect MinnesotaCare, the state’s health insurance program for low-income residents), she has typically demonstrated lukewarm interest in a single-payer system.
But this year, Berglin has signed on as a coauthor of the Minnesota Health Act, the bill that would create the Minnesota Health Plan. The Act (HF 135, SF 118) would take health insurance out of the private sector and put it under the control of a state board to cover all Minnesotans.
Citizens would be free to choose their own physicians or practitioners and would not be subject to any preexisting conditions clauses. The premiums that employees and employers currently pay would go into the state-run system, and each user would pay premiums according to his or her ability to pay. Advocates say those premiums will shrink for everyone under the plan.
When asked why Berglin seemed to have changed her mind on the single-payer plan, her office said her position is not quite a break from the past: “She has supported this bill in the past, so her support is not new.”
But this year, as the bill’s co-sponsor, she has brought that advocacy to a new level.
Berglin is not alone, as the bill is seeing more profound backing this year than in the previous 15 years or so that it’s been up for consideration.
While conservatives decry the plan as costly, advocates point to a number of ways a state-run health care plan could stimulate the economy.
“It makes the entire health care system less costly by making it more efficient,” said health policy expert Kip Sullivan, who has been active in Minnesota’s push for a single-payer system.
“The largest single improvement in efficiency under the plan will be the elimination of the excessive administrative costs created by health insurance companies,” he said.
Supporters expect the system to generate a 20 percent savings in health care costs. Those lowered costs would attract businesses to the state, they argue.
“[The plan] is especially beneficial to smaller employers because they are the least likely to be able to afford health insurance under the current system,” said Sullivan.
Indeed, small businesses are struggling to cover their employees and themselves, according to a study of 1,200 small businesses released this month (pdf) by the Main Street Alliance. Only 34 percent of small employers offer health coverage for their employees, and 43 percent of those only offered coverage for the business owner. Almost half, 49 percent, said that “any insurance, even bare bones coverage, is too expensive.”
Among small business owners, 59 percent said they would support a public solution to rising health care costs, compared to just 26 percent who said they’d rather let the private market sort the problem out.
Sullivan says that in addition to helping struggling small businesses, the Minnesota Health Plan could have a positive impact on the foreclosure crisis.
“Another benefit that will materialize in both good and bad economic times is fewer personal bankruptcies and home mortgage foreclosures, both of which are caused to a large extent by medical bills people can’t afford to pay.”
And as the foreclosure crisis continues to unfold in the United States, several studies have shown that just under half of all foreclosures were precipitated by medical crises, and one-quarter were due directly to insurmountable medical costs.
Under the Minnesota Health Plan, advocates say, those medical crises would be muted.
The bill co-sponsored by Berglin has two dozen coauthors in the Senate and three dozen in the House, but even with that support it’s unclear whether the measure will make it out of committee, as more conservative DFLers tend to support a free-market approach. In the past, single-payer bills have not reached the Minnesota House or Senate floors for votes.
And even if it does, passing the Legislature and making it to Gov. Tim Pawlenty’s desk most certainly means a veto.
“Those of us supporting the Minnesota Health Plan expect it will take multiple sessions of the Legislature to get it passed,” said Sullivan.
“What’s different now is that a single-payer bill like the Minnesota Health Act is actually being heard in the Legislature. That is the first step to educating the Legislature, the media and the public about the need for a single-payer solution to the crisis.”